Factors Causing Disagreement between Measured and Calculated Low Density Lipoprotein-Cholesterol (LDL-C) in Clinical Laboratory Services

Lekskulchai, Veeravan

doi:10.12659/msmbr.907751

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…However, these studies were conducted with older versions of the dLDL reagents or on older analytical platforms (See Supplementary Table E). Studies specifically using more recent Roche assays and platforms agree with our findings that cLDL underestimated dLDL at all levels of TG and LDL, and that using cLDL would misclassify more patients as having a lower CVD risk [26,27]. One obstacle preventing a standard consensus between dLDL assays is that lipid assay standardization needs improvement [33].…”

Section: Discussionsupporting

confidence: 77%

“…In these 32 cases with a negative cLDL, the dLDL assay was still able to produce a measurable dLDL result in all of them ranging from 4.3-66.5 mg/dL (0.11-1.72 mmol/L). The Friedewald equation also assumes an absence of chylomicrons and remnant lipoproteins, which may not be true in non-fasting samples and is more likely to be affected by fluctuations in TG in the non-fasting state [27,41]. However, fasting for dLDL testing is not required as the influence of food intake on dLDL is minimal [42][43][44].…”

Section: Discussionmentioning

confidence: 99%

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A Contemporary Evaluation of Calculated and Directly Measured LDL

CS¹,

WJ²,

SK³

2021

Jap J Clin & Med Res

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Background: There are few contemporary evaluations of directly measured LDL (dLDL) assays. We evaluated the performance of the Roche Gen.3 dLDL assay and compared it to the Friedewald LDL (cLDL) in a large cohort, tested on the Cobas c702 analyser. Methods: We evaluated assay precision, linearity, and limit of detection (LOD). To compare cLDL/dLDL, lipid panels (TC/TG/HDL/cLDL) from 2017- 2019 (n=117,090) were tested for dLDL. Samples with TG >400mg/dL (4.5mmol/L) (n=605) and negative cLDL (n=32) were excluded. We examined the difference between cLDL/dLDL (n=116,453), the influence of increasing levels of TG/LDL on their measurements, and how cLDL/dLDL classified cardiovascular risk by LDL levels. Results: The Roche dLDL assay has a CV of 1.0%/0.9% at 58.4/106.4mg/dL, is linear from 19.4-374mg/dL, and has a verified LOD of 4.2mg/dL. Despite close agreement between dLDL/cLDL [Pearson r=0.98 (95%CI 0.9795-0.9800)], cLDL underestimates dLDL in 98.5% (n=114,750) of subjects across all levels of LDL/TG. The underestimation increases with LDL/TG levels. cLDL classified more subjects (63.5%) as having a desirable LDL (<100mg/dL) than dLDL (46.9%). Conclusions: The Cobas c702 dLDL assay performs well, and contemporary cLDL results underestimate dLDL across all levels of TG/LDL. cLDL classifies more patients into lower cardiovascular risk categories than dLDL

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

A Contemporary Evaluation of Calculated and Directly Measured LDL

CS¹,

WJ²,

SK³

2021

Jap J Clin & Med Res

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Appropriateness of Using Tests for Blood Glucose and Diabetic Complications in Clinical Practice: Experiences in a Hospital in Thailand

Lekskulchai

2018

Med Sci Monit

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BackgroundThis study aimed to evaluate how the tests for blood glucose (BG) and diabetic complications have been utilized in a hospital in Thailand.Material/MethodsPatient medical records having the results of BG, HbA1c, and/or urine microalbumin presented and the records of DM patients having the results of serum lipids, serum LDL-C, and/or serum creatinine presented were selected. The data of diagnosis, ordered tests, and testing results in these records were extracted for evaluation.ResultsThis study recruited 1066 patients diagnosed with DM and 3081 patients diagnosed with other diseases. Point-of-care testing (POCT) for BG was repeatedly used in 371 non-DM cases; most of its results were normal. The results of BG and HbA1c were often used together. There was a good relationship between them, and these test results indicated poor glycemic control in 58% of DM cases. In non-DM cases, the test results agreed, indicating normoglycemia in 17.32%, pre-diabetes in 20.47%, and diabetes in 21.78%. To prevent diabetic nephropathy, serum creatinine was frequently used, whereas urine microalbumin, the recommended test, was underutilized. The result of LDL-C from both direct measurement and calculation were used; however, based on the same guidelines, the results of measured LDL-C indicated risk of cardiovascular diseases in a higher percentage of DM cases than did the results of calculated LDL-C.ConclusionsThe use of POCT for BG in hospitalized patients may be inappropriate. The utilization of urine microalbumin should be promoted to effectively prevent diabetic nephropathy.

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Factors Causing Disagreement between Measured and Calculated Low Density Lipoprotein-Cholesterol (LDL-C) in Clinical Laboratory Services

Cited by 2 publications

References 24 publications

A Contemporary Evaluation of Calculated and Directly Measured LDL

A Contemporary Evaluation of Calculated and Directly Measured LDL

Appropriateness of Using Tests for Blood Glucose and Diabetic Complications in Clinical Practice: Experiences in a Hospital in Thailand

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